CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Hospital Metropolitano Dr Pila

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $79
Cash Discount Price: $100
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Hospital Metropolitano Dr Pila is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.50x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)

Cash / Self-Pay: $100 (64%)

Insurance Median: $79 (50%)

Cash: $100 (64% of Medicare)

Ins. Median: $79 (50% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
First Medical	$37 - $40	24%
Plan De Salud Menonita	$38 - $69	24%
Privado	$40	25%
Corvel Corporation	$42	27%
Triple S	$57 - $124	36%
Mcs	$61 - $116	39%
Mso	$70 - $83	45%
Humana	$79	50%
Prossam	$85	54%
Comerciales	$86	55%
Mapfre	$108	69%
Bl	$112	71%
Tricare	$116	74%
Ch	$121	77%
Medicare (plans)	$121	77%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $100.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hospital Metropolitano Dr Pila is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.